Gastric tubes having tethered plugs and methods of use

ABSTRACT

A gastric tube for use in a bariatric procedure includes an elongate tube and a cannulated plug coupled to the elongate tube. The elongate tube has a proximal end portion and a distal end portion. The elongate tube defines a lumen along a length thereof. The proximal end portion defines an opening in communication with the lumen. The elongate tube includes a blunt tip and an outer surface. The blunt tip is formed on the distal end portion. The outer surface defines a side opening in communication with the lumen. The cannulated plug includes a proximal end and a distal end. The proximal end is configured for connection to a vacuum source. The distal end is configured for removable receipt in the opening of the proximal end portion of the elongate tube to control a flow of one of aspiration and irrigation through the lumen.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. patentapplication Ser. No. 14/276,303 filed on May 13, 2014, the entirecontents of which is incorporated by reference herein.

TECHNICAL FIELD

The present disclosure generally relates to surgical instruments, andmore particularly, to a gastric tube having a tethered plug used inbariatric procedures.

BACKGROUND

Obesity is reaching epidemic proportions in many regions of the world,particularly in the United States. In order to treat obesity, variousbariatric procedures have been developed including, for example, gastricbypass, adjustable gastric banding, and sleeve gastrectomy. The goal ineach of these procedures is to reduce the stomach capacity to restrictthe amount of food that the patient can eat. The reduced stomachcapacity, in turn, results in a feeling of fullness for the patientafter ingesting a relatively smaller amount of food. Thus, the patientcan achieve significant weight loss.

Sleeve gastrectomy involves transecting a stomach, e.g., using astapling device or other suitable device, to reduce a stomach volume.Sleeve gastrectomy procedures are often aided by the use of a gastrictube, which serves as a guide or template for transecting the stomach tothe appropriate configuration while inhibiting inadvertent transectionof stomach or esophageal tissue. Once the stomach has been appropriatelytransected, the gastric tube is removed and a leak test is performed todetermine whether there are any areas of extravasation.

In use, the gastric tube may be advanced into a patient's body throughan oral cavity and down through the esophagus into the stomach toprovide delineation of the antrum of the stomach, irrigation/suction offluids, and/or a sizing of a gastric pouch. While being advanced, due atleast in part to the circuitous nature of this track, a clinician mayneed to reposition the gastric tube in various orientations until thegastric tube is properly aligned or bypasses any obstruction(s).

Accordingly, a more flexible gastric tube would aid a clinician innavigating the gastric tube through body cavities of a patient. Further,a more efficient way of connecting and disconnecting a vacuum sourcewith the gastric tube would avoid vacuum pressure loss and/or spillageof bodily fluid.

SUMMARY

According to one aspect of the present disclosure, a gastric tube foruse in a bariatric surgical procedure is provided. The gastric tubeincludes an elongate tube and a cannulated plug attached to the elongatetube. The elongate tube has a proximal end portion and a distal endportion. The elongate tube defines a lumen along a length thereof. Theproximal end portion defines an opening in communication with the lumen.The elongate tube includes a blunt tip and an outer surface. The blunttip is formed on the distal end portion. The outer surface extendsbetween the proximal and distal end portions and defines a side openingin communication with the lumen. The side opening is configured anddimensioned for at least one of aspiration and irrigation.

The cannulated plug includes a proximal end and a distal end. Theproximal end is configured for connection to a vacuum source. The distalend is configured for removable receipt in the opening of the proximalend portion of the elongate tube to control a flow of one of aspirationand irrigation through the lumen.

In embodiments, the plug may include a tether attached to the outersurface of the elongate tube. In further embodiments, the plug mayinclude a radial extension and the elongate tube may include an innersurface. The radial extension may have an outer diameter equal to adiameter of the opening of the proximal end portion such that the radialextension is frictionally engaged with the inner surface of the elongatetube when the plug is received in the opening. In some embodiments, theplug may taper between the proximal end and the distal end thereof. Thedistal end of the plug may include a plurality of stacked conicalbodies. It is contemplated that the plug may include a valve resilientlybiased towards a closed position.

In some aspects of the present disclosure, the elongate tube may bepliable. In embodiments, the tip of the elongate tube may have anarcuate outer surface. The elongate tube may further include a recessformed in the tip configured for at least one of aspiration andirrigation. The elongate tube may further include a plurality of depthmarkings formed along at least a portion of the outer surface.

In embodiments, the gastric tube may further include a balloon supportedon the elongate tube configured to receive an inflation medium toinflate the balloon.

In embodiments, the gastric tube may further include a movable componentattached to the outer surface. The movable component may be movablebetween an unexpanded position in which the movable component isdisposed in abutting engagement with the outer surface and an expandedposition in which a distal portion of the movable component bowsoutwardly from the outer surface of the elongate tube. The movablecomponent may be slidably coupled to the proximal end portion of theelongate tube and fixedly coupled to the distal end portion of theelongate tube.

According to another aspect of the present disclosure, a method ofperforming a bariatric procedure is provided. The method includesproviding a gastric tube including an elongate tube and a cannulatedplug coupled to the elongate tube. The elongate tube has a proximal endportion and a distal end portion. The elongate tube defines a lumenalong a length thereof. The proximal end portion defines an opening incommunication with the lumen. The elongate tube includes a blunt tip andan outer surface. The blunt tip is formed on the distal end portion. Theouter surface extends between the proximal and distal end portions anddefines a side opening in communication with the lumen. The side openingis configured and dimensioned for at least one of aspiration andirrigation

The cannulated plug includes a proximal end and a distal end. Theproximal end is configured for connection to a vacuum source. The distalend is configured for removable receipt in the opening of the proximalend portion of the elongate tube to control a flow of one of aspirationand irrigation through the lumen.

The method further includes inserting the gastric tube into an oralcavity of a patient; guiding the gastric tube along an enteral pathway;repositioning the gastric tube based on an observed position of the tipto a selected position within a stomach of the patient; aspirating fluidfrom the stomach through the side opening of the elongate tube;anchoring the gastric tube to the selected position within the stomach;and transecting a portion of the stomach.

In embodiments, the method may further include removing the plug fromthe opening of the proximal end portion.

In some aspects of the present disclosure, anchoring the gastric tubemay include inflating a balloon supported on the elongate tube with aninflation medium to wedge the balloon between inner surfaces of thestomach.

In embodiments, guiding the gastric tube along the enteral pathway mayinclude advancing the gastric tube from an oral cavity through anesophagus and into an antrum of a stomach.

In some embodiments, the method may further include moving a movablecomponent supported on the elongate tube from an unexpandedconfiguration to an expanded configuration in which the movablecomponent bows outwardly from the outer surface of the elongate tubeinto engagement with a portion of the stomach. Moving the movablecomponent may include sliding the movable component in a distaldirection relative to the elongate tube.

In further embodiments of the present disclosure, the plug may include atether attached to the outer surface of the elongate tube. The plug mayinclude a plurality of stacked conical bodies.

Other aspects, features, and advantages of the present disclosure willbe apparent from the description, the drawings, and the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the disclosureand, together with a general description of the disclosure given above,and the detailed description of the embodiment(s) given below, serve toexplain the principles of the disclosure, wherein:

FIG. 1 is a side view of an illustrative embodiment of a gastric tubebeing navigated through an enteral pathway of a patient into a stomachof the patient in accordance with the principles of the presentdisclosure;

FIG. 2 is a side view, in part cross section and in part phantom, of thegastric tube shown in FIG. 1;

FIG. 3 is a cross section of the plug of the gastric tube taken alongline 3-3 in FIG. 2;

FIG. 4 is an expanded view of depth markings of the gastric tube shownin FIG. 1;

FIGS. 5 and 6 are progressive side views of the gastric tube shown inFIG. 1 aspirating bodily fluid from within a stomach;

FIG. 7 is a side view of the gastric tube shown in FIG. 5 secured to astomach;

FIG. 8 is a perspective view of another illustrative embodiment of agastric tube having a movable component disposed in an unexpandedposition in accordance with the principles of the present disclosure;and

FIG. 9 is perspective view of the gastric tube shown in FIG. 7 with themovable component disposed in an expanded position.

DETAILED DESCRIPTION

As used herein, the term “clinician” refers to a doctor, nurse, or othercare provider and may include support personnel. The terms “proximal” or“trailing” each refer to the portion of a structure closer to aclinician, and the terms “distal” or “leading” each refer to a portionof a structure farther from the clinician.

Referring now to FIG. 1, a gastric tube 100 includes an elongate tube110, a cannulated plug 120 coupled to the elongate tube 110 andconfigured for connection with a vacuum source 152 (FIG. 5), and ananchor, such as, for example, an inflatable balloon member 140 supportedon the elongate tube 110.

In use, as described in further detail below with reference to FIGS.5-7, the gastric tube 100 is inserted into an oral cavity (e.g., a mouth“M”) of a patient and is advanced distally (e.g., caudally) along anenteral pathway “EP” that includes a track that extends between oralcavity “M” and a stomach “ST” of the patient. When positioned in thestomach “ST” of the patient (e.g., the antrum or lower part of thestomach), the balloon member 140 can be secured within or fixed to thestomach “ST” by, for example, inflating the balloon member 140 and aidthe clinician in performing a bariatric surgical procedure such as asleeve gastrectomy. Prior to and/or after inflating the balloon member140, vacuum source 152 is connected to the plug 120 and activated todraw or aspirate fluids from the stomach “ST.”

With reference to FIGS. 1-4, the elongate tube 110 can be formed of anymaterial with sufficient flexibility to enable the elongate tube 110 tomaneuver along the patient's track or enteral pathway “EP” between theoral cavity “M” and the stomach “ST.” In embodiments, elongate tube 110is fabricated from an elastomer, such as, for example, a siliconecontaining material. The elongate tube 110 includes a trailing endportion or proximal end portion 110 a and a leading end portion ordistal end portion 110 b. Elongate tube 110 defines a curved length thatextends between the proximal and distal end portions 110 a, 110 b. It iscontemplated that elongate tube 110 can be linear, arcuate, or any shapesuitable for a particular bariatric surgical procedure. Elongate tube110 defines a lumen 116 extending along and through the length ofelongate tube 110. The lumen 116 is in fluid communication with sideopenings 116 a, 116 b defined in an outer surface 118 a of elongate tube110 adjacent distal end portion 110 b.

Proximal end portion 110 a includes an opening 117 in communication withlumen 116. Opening 117 of proximal end portion 110 a is configured forremovable receipt of cannulated plug 120, as will be described ingreater detail below. Distal end portion 110 a includes a distal tip112. Distal tip 112 has a blunt, arcuate outer surface 122 a such thatpenetration of tissue during the advancement of elongate tube 110through internal body cavities of a patient is resisted and/orprevented. In some embodiments, distal tip 112 can be variouslyconfigured, such as, for example, oval, oblong, tapered, uniform,non-uniform, smooth, polished, and/or rounded. Distal tip 112 furtherincludes an arcuate inner surface 122 b separated from outer surface 122a by a thickness of distal tip 112. Distal tip 112 defines a distalrecess or opening 114 a defined in a leading end of the distal tip 112and extending between inner and outer surfaces 122 a, 122 b. The sideopenings 116 a, 116 b and distal opening 114 a together function as aninlet that draws bodily fluids in when lumen 116 is coupled to a vacuumsource 152 (FIG. 5). The vacuum source 152 couples to lumen 116 via plug120 to aspirate bodily fluids out of a surgical site such as an antrumof a stomach.

Gastric tube 100 further includes cannulated plug 120 coupled toelongate tube 110. Plug 120 includes a tether 124 attached to outersurface 118 a of elongate tube 110. Plug 124 tapers from a proximal end126 a to a distal end 126 b thereof. Proximal end 126 a is configuredfor detachable connection with vacuum source 152 such that a pressuredifferential can be generated within plug 120. Plug 120 includes aradial extension 128 disposed about proximal end 126 a. Radial extension128 has an outer diameter equal to a diameter of opening 117 of proximalend portion 110 a (i.e., inner diameter of tube 110) such that radialextension 128 is frictionally engaged with an inner surface 118 b ofelongate tube 110 when plug 120 is received within opening 117. In thisway, fluid and/or air is resisted and/or prevented from passing betweenradial extension 128 and inner surface 118 b of elongate tube 110.

Distal end 126 b of plug 120 is configured for removable receipt inopening 117 of proximal end portion 110 a of elongate tube 110 tocontrol flow of one of aspiration and irrigation through lumen 116 ofelongate tube 110. Distal end 126 b includes a plurality of stackedconical bodies 130 that increase the strength of the connection of plug120 with elongate tube 110. Conical bodies 130 taper in aproximal-distal direction along plug 120.

Plug 120 defines a passageway 132 extending from proximal end 126 a todistal end 126 b. Passageway 132 includes a pressure valve 134 disposedtherein. Pressure valve 134 is resiliently biased to a closedconfiguration in which pressure valve 134 resists and/or prevents fluidfrom passing through passageway 132. When a pressure differentialgenerated by vacuum source 152 reaches a selected threshold value, theresilient bias of valve 134 is overcome such that valve 134 moves to anopen position in which fluid is free to pass through passageway 132.

With reference to FIG. 4, the elongate tube 110 may include one or moredepth markings 160 on outer surface 118 a of elongate tube 110 thatfunction as an indicator for an insertion depth of the gastric tube 100along the enteral pathway “EP” of the patient.

With reference to FIGS. 5-7, gastric tube 100 may further include ananchor, such as, for example, an inflatable balloon member 140 securedto elongate tube 110. Balloon member 140 is configured to fix elongatetube 110 within a patient's stomach. Balloon member 140 can be in theform of a toroid that is disposed about outer surface 118 a of distalend portion 110 b such that distal tip 112 protrudes distally fromballoon member 140. Balloon member 140 is positioned along outer surface118 a without blocking side openings 116 a, 116 b. It should beappreciated that, as used herein, the term inflatable balloon memberrefers to any structure defining a volume that is expandable uponintroduction of fluid into the volume, and thus can include a unitaryarrangement of material and/or a multi-component arrangement securedtogether to form, for example, a bladder.

An inflation lumen (not shown) is defined in the elongate tube 110 thatis in fluid communication with balloon member 140. The balloon member140 is adapted to receive inflation fluid (e.g., saline) through theinflation lumen when the inflation lumen is coupled to fluid source 154adapted to deliver the inflation fluid. Alternatively, and/oradditionally, the inflation lumen couples to vacuum source 152 adaptedto create a vacuum in the inflation lumen to draw inflation fluid fromwithin the balloon member 140 out of the balloon member 140 to deflatethe balloon member 140. As appreciated, the fluid and/or vacuum sources152, 154 enable a clinician to control the size of the balloon member140 as desired.

In an exemplary use, as illustrated in FIGS. 5-7, the gastric tube 100is inserted into a patient, such as, for example, an oral cavity “M” ofa patient and is advanced distally toward the stomach “ST” along enteralpathway “EP,” which extends from the oral cavity “M,” through theesophagus “E,” and into the stomach “ST.” The gastric tube 100 isselectively repositioned based on observed positions of the distal tip112 along the enteral pathway “EP.” Gastric tube 100 is further guidedthrough the esophagus “E” and selectively positioned within the stomach“ST” of the patient.

Upon positioning the gastric tube 100 within the stomach “ST,” thevacuum source 152 functions to aspirate bodily fluid “F” in the stomach“ST.” In particular, actuation of the vacuum source 152 creates apressure differential that overcomes the resilient bias of valve 134 tomove valve 134 from the closed position to the open position. With valve134 in the open position, pressure is generated in the lumen 116 anddraws the bodily fluid “F” into the distal opening 114 a of the distaltip 112 and/or side openings 116 a, 116 b of elongate tube 110 forproximal extraction of the bodily fluid “F” through lumen 116,passageway 132 of plug 120 and out of proximal opening 117 of elongatetube 110. As can be appreciated, the vacuum source 152 can also functionto collapse the stomach “ST” or portions thereof to facilitate anysuitable bariatric procedure such as a sleeve gastrectomy.

When aspiration of bodily fluid “F” is completed, vacuum source 152 isdeactivated such that valve 134 moves from the open position to theclosed position in which fluid cannot leak in a distal direction throughlumen 116 back into the stomach “ST.” In some embodiments, alternativelyto deactivating vacuum source 152, valve 134 or any type of suitablevalve described herein can be manually closed to resist and/or preventfluid from passing through passageway 132. Plug 120 may be removed fromopening 117 of proximal end portion 110 a while remaining connected tovacuum source 152 to free up opening 117 for connection to anotherdevice, such as, for example, a fluid source 154.

As shown in FIG. 7, the fluid source 154 couples to the gastric tube 100to partially and/or wholly inflate the balloon 140 to anchor the gastrictube 100 within the selected position within the stomach “ST” (e.g., theantrum) and aid the clinician in performing the bariatric surgicalprocedure. In some embodiments, fluid source 154 is coupled to elongatetube 110 via plug 120. As the balloon member 140 is inflated withinflation medium, balloon member 140 is wedged between a first innersurface or a lesser curvature portion “C1” of stomach “ST” and a secondinner surface or greater curvature portion “C2” of stomach “ST.” Withthe balloon 140 deflated, a clinician can remove or transect a largeportion of the stomach “ST” and staple the remaining portion together.In certain procedures, this is done to limit the size of the patient'sstomach “ST” for helping the patient lose weight.

Referring now to FIGS. 7 and 8, another embodiment of a gastric tube200, similar to gastric tube 100 discussed above, is shown. In general,the gastric tube 200 includes an elongate tube 210 having a plurality ofopenings or apertures 228 and coupled to a cannulated plug 220, similarto plug 120 discussed above, configured for connection with a vacuumsource 252, and a rod member or movable component 230 coupled toelongate tube 210. When suction is applied to elongate tube 210,elongate tube 210 can adhere to tissue, such as, for example, stomachtissue, due to the plurality of openings 228. In embodiments, thegastric tube 100 described with regard to FIGS. 1-7 may also includemovable component 230 translatably or slidably coupled to elongate tube110 thereof.

The elongate tube 210 includes a trailing end portion or proximal endportion 210 a and a leading end portion or distal end portion 210 b.Elongate tube 210 defines a curved length that extends between theproximal and distal end portions 210 a, 210 b. Elongate tube 210 definesa lumen 216 extending along and through the length of elongate tube 210.Elongate tube 210 further includes a plurality of openings or apertures228 extending between an outer surface 218 and an inner surface (notshown) of elongate tube 210. Apertures 228 provide for fluidcommunication between lumen 216 and an environment exterior to elongatetube 210. Proximal end portion 210 a includes an opening 217 configuredfor removable receipt of plug 220. Distal end portion 210 b includes adistal tip 212, similar to distal tip 112 discussed above.

Gastric tube 200 further includes cannulated plug 220 coupled toelongate tube 210. Plug 220 includes a tether 224 attached to outersurface 218 of elongate tube 210. Plug 220 tapers from a proximal end226 a to a distal end 226 b thereof. Proximal end 226 a is configuredfor detachable connection with a vacuum source 252 such that a pressuredifferential can be generated within plug 220. Plug 220 includes aradial extension 228 disposed about proximal end 226 a. Radial extension228 has an outer diameter equal to a diameter of opening 217 of proximalend portion 210 a (i.e., inner diameter of tube 210) such that radialextension 228 is frictionally engaged with the inner surface (not shown)of elongate tube 210 when plug 220 is received within opening 217. Inthis way, fluid and/or air is resisted and/or prevented from passingbetween radial extension 228 and the inner surface of elongate tube 210.

Distal end 226 b of plug 220 is configured for removable receipt inopening 217 of proximal end portion 210 a of elongate tube 210 tocontrol flow of one of aspiration and irrigation through lumen 216 ofelongate tube 210. Distal end 226 b includes a plurality of stackedconical bodies 231 that increase the strength of the connection of plug220 with elongate tube 210. Conical bodies 231 taper in aproximal-distal direction along plug 220.

Plug 220 defines a passageway 232 extending from proximal end 226 a todistal end 226 b. Passageway 232 includes a pressure valve (not shown),similar to pressure valve 134 discussed above, disposed therein. Thepressure valve is resiliently biased to a closed configuration in whichpressure valve resists and/or prevents fluid from passing throughpassageway 232. When a pressure differential generated by vacuum source252 reaches a selected threshold value, the resilient bias of thepressure valve is overcome such that the pressure valve moves to an openposition in which fluid is free to pass through passageway 232.

Gastric tube 200 includes a movable component 230 coupled to elongatetube 210. Movable component 230 is formed from a semi-rigid, resilientlyflexible material, e.g., a suitable elastomer, and defines a lengthgreater than the length of elongate tube 210 such that movable component230 can be accessed outside the patient and/or remotely of the surgicalsite. Movable component 230 defines a distal portion 242 having a distalend 243 and a proximal portion 244. Distal end 243 of movable component230 is integrally, i.e., monolithically, formed with or otherwiseaffixed to distal tip 212. A coupling 246, e.g., a ring, sleeve, hook,latch, etc., affixed to elongate tube 210 slidably receives a portion ofmovable component 230 therethrough to slidably couple movable component230 to elongate tube 210 intermediate the distal and proximal endportions 210 a, 210 b of elongate tube 210.

As a result of the above-configuration, movable component 230 isslidable through coupling 246 and relative to elongate tube 210 betweenan unexpanded or contracted position and an expanded or deployedposition. The unexpanded position corresponds to a first condition ofgastric tube 200, as shown in FIG. 8, wherein distal portion 242 ofmovable component 230 extends along and is in abutting engagement withthe outer surface 218 of elongate tube 210 and is in substantiallyparallel relation relative thereto. The expanded position corresponds toa second condition of gastric tube 200, as shown in FIG. 9, whereindistal portion 242 of movable component 230 is bowed outwardly fromelongate tube 210 and is spaced therefrom. In the expanded position,movable component 230 defines a configuration that generally complementsthe curvature of a greater curvature portion of a stomach (FIG. 7).

Proximal portion 244 of movable component 230 may be grasped andmanipulated relative to elongate tube 210 to transition movablecomponent 230 between the unexpanded and expanded positions. Asmentioned above, movable component 230 is dimensioned such that proximalportion 244 is accessible from outside the patient, thus readilyenabling manipulation thereof. More specifically, translating movablecomponent 230 distally relative to elongate tube 210 and coupling 246urges movable component 230 distally through coupling 246 such thatdistal portion 242 of movable component 230 is bowed outwardly relativeto elongate tube 210 towards the expanded position. Translating movablecomponent 230 proximally relative to elongate tube 210 pulls movablecomponent 230 proximally through coupling 246 such the distal portion242 of movable component 230 is pulled inwardly relative to elongatetube 210 towards the unexpanded position.

In an exemplary use, with movable component 230 in the unexpandedposition, the gastric tube 200 is inserted into a patient, such as, forexample, an oral cavity of a patient and is distally advanced toward astomach of the patient along an enteral pathway that extends from theoral cavity, through an esophagus of the patient, and into the stomach,as described above with regard to FIGS. 1-7. Gastric tube 200 is guidedalong the enteral pathway via observation of the distal tip 212. Thegastric tube 200 is selectively repositioned based on observed positionsof the distal tip 212 along the enteral pathway. Gastric tube 200 isfurther guided through the esophagus and selectively positioned withinthe stomach of the patient.

Upon positioning the gastric tube 200 within the stomach, proximalportion 244 of movable component 230 is translated distally relative toelongate tube 210 such that distal portion 242 of movable component 230bows outwardly relative to elongate tube 210 towards the expandedposition. As distal portion 242 of movable component 230 bows outwardlytowards the expanded position, elongate tube 210 is urged towards andinto complementary mating relation with the lesser curvature portion ofthe stomach, while distal portion 242 of movable component 230 is urgedtowards and into complementary mating relation with the greatercurvature portion of the stomach. As such, the orientation of gastrictube 200 with elongate tube 210 extending along the lesser curvatureportion of the stomach between the esophageal sphincter and the pyloricsphincter can be readily achieved. As a result of this configuration ofgastric tube 200 in the expanded position, the above-describedorientation of gastric tube 200 within the stomach is maintained despitespasms, folding, spiraling, and/or shifting of the stomach.

Once the proper orientation of elongate tube 210 has been achieved,suction is applied within lumen 216 for suctioning any remainingcontents within the stomach into lumen 216 of elongate tube 210 throughapertures 228. In particular, actuation of the vacuum source 252 createsa pressure differential that overcomes the resilient bias of thepressure valve to move valve from the closed position to the openposition. With the pressure valve in the open position, pressure isgenerated in lumen 216 and draws the bodily fluid from the stomach intothe apertures 228 of elongate tube 210 for proximal extraction of thebodily fluid through lumen 216, passageway 232 of plug 220 and out ofproximal opening 217 of elongate tube 210.

Application of suction within lumen 216 also suctions the lessercurvature portion of the stomach to the outer surface or periphery 218of elongate tube 210, to ensure and maintain the complementary matingrelation of elongate tube 210 with the lesser curvature portion of thestomach.

With elongate tube 210 maintained in position relative to the lessercurvature portion of the stomach as a result of the applied suction,proximal portion 244 of movable component 230 is translated proximallyrelative to elongate tube 210 such that the distal portion 242 ofmovable component 230 is pulled inwardly relative to elongate tube 210back to the unexpanded position. As suction is maintained at this point,elongate tube 210 is maintained in the position detailed above despitecontraction of distal portion 242 of movable component 230.

Once distal portion 242 of movable component 230 has been returned tothe unexpanded position, transection of the stomach adjacent elongatetube 210 on an opposite side of elongate tube 210 relative to the lessercurvature portion of the stomach may be effected in any suitablefashion, e.g., using a stapling device or other suitable device.Transection in this manner reforms the stomach to a tubular-shapedconfiguration that generally approximates the outer dimension ofelongate tube 210 and extends between the esophageal sphincter and thepyloric sphincter. As can be appreciated, the diameter of elongate tube210 may be selected in accordance with a desired diameter of thetubular-shape reformed stomach.

When transaction is completed, vacuum source 252 is deactivated suchthat the pressure valve moves from the open position to the closedposition in which fluid cannot leak in a distal direction through lumen216 back into the stomach. Plug 220 may be removed from opening 217 ofproximal end portion 210 a while remaining connected to vacuum source252 to free up opening 217 for connection to another device, such as,for example, a fluid source.

Persons skilled in the art will understand that the structures andmethods specifically described herein and shown in the accompanyingfigures are non-limiting exemplary embodiments, and that thedescription, disclosure, and figures should be construed merely asexemplary of particular embodiments. It is to be understood, therefore,that the present disclosure is not limited to the precise embodimentsdescribed herein, and that various other changes and modifications maybe effected by one skilled in the art without departing from the scopeor spirit of the disclosure. Additionally, the elements and featuresshown or described in connection with certain embodiments may becombined with the elements and features of certain other embodimentswithout departing from the scope of the present disclosure, and thatsuch modifications and variations are also included within the scope ofthe present disclosure. Accordingly, the subject matter of the presentdisclosure is not limited by what has been particularly shown anddescribed.

1-21. (canceled)
 22. A gastric tube for use in a bariatric procedure,the gastric tube comprising: an elongate tube having a proximal endportion and a distal end portion, the elongate tube defining a lumenalong a length thereof, the proximal end portion defining an opening incommunication with the lumen, the elongate tube including: a blunt tipformed on the distal end portion; and an outer surface that extendsbetween the proximal and distal end portions and defines a side openingin communication with the lumen, the side opening configured anddimensioned for at least one of aspiration or irrigation; and acannulated plug coupled to the elongate tube, the cannulated plugincluding: a valve resiliently biased towards a closed position; aproximal end configured for connection to a vacuum source; and a distalend configured for removable receipt in the opening of the proximal endportion of the elongate tube to control a flow of one of aspiration orirrigation through the lumen.
 23. The gastric tube as recited in claim22, wherein the cannulated plug includes a tether attached to the outersurface of the elongate tube.
 24. The gastric tube as recited in claim22, wherein the cannulated plug includes a radial extension and theelongate tube includes an inner surface, wherein the radial extensionhas an outer diameter equal to a diameter of the opening of the proximalend portion such that the radial extension is frictionally engaged withthe inner surface of the elongate tube when the cannulated plug isreceived in the opening.
 25. The gastric tube as recited in claim 22,wherein the cannulated plug tapers between the proximal end and thedistal end thereof.
 26. The gastric tube as recited in claim 25, whereinthe distal end of the cannulated plug includes a plurality of stackedconical bodies.
 27. The gastric tube as recited in claim 22, wherein theelongate tube is pliable.
 28. The gastric tube as recited in claim 22,further including a plurality of depth markings formed along at least aportion of the outer surface of the elongate tube.
 29. The gastric tubeas recited in claim 22, further including a movable component attachedto the outer surface of the elongate tube, the movable componentincluding a distal portion, the movable component being movable betweenan unexpanded position in which the movable component is disposed inabutting engagement with the outer surface of the elongate tube and anexpanded position in which the distal portion of the movable componentbows outwardly from the outer surface of the elongate tube.
 30. Thegastric tube as recited in claim 29, wherein the movable component isslidably coupled to the proximal end portion of the elongate tube andfixedly coupled to the distal end portion of the elongate tube.
 31. Agastric tube for use in a bariatric procedure, the gastric tubecomprising: an elongate tube having a proximal end portion and a distalend portion, the elongate tube defining a lumen along a length thereof,the proximal end portion defining an opening in communication with thelumen, the elongate tube including: a blunt tip formed on the distal endportion; and an outer surface that extends between the proximal anddistal end portions and defines a side opening in communication with thelumen, the side opening configured and dimensioned for at least one ofaspiration or irrigation; and a cannulated plug coupled to the elongatetube, the cannulated plug including: a proximal end configured forconnection to a vacuum source; and a distal end configured for removablereceipt in the opening of the proximal end portion of the elongate tubeto control a flow of one of aspiration or irrigation through the lumen,wherein the distal end of the cannulated plug includes a plurality ofstacked conical bodies.
 32. The gastric tube as recited in claim 31,wherein the cannulated plug includes a valve resiliently biased towardsa closed position.
 33. The gastric tube as recited in claim 31, whereinthe cannulated plug includes a tether attached to the outer surface ofthe elongate tube.
 34. The gastric tube as recited in claim 31, whereinthe cannulated plug includes a radial extension and the elongate tubeincludes an inner surface, wherein the radial extension has an outerdiameter equal to a diameter of the opening of the proximal end portionsuch that the radial extension is frictionally engaged with the innersurface of the elongate tube when the cannulated plug is received in theopening.
 35. The gastric tube as recited in claim 31, wherein thecannulated plug tapers between the proximal end and the distal endthereof.
 36. The gastric tube as recited in claim 31, further includinga plurality of depth markings formed along at least a portion of theouter surface.
 37. The gastric tube as recited in claim 31, furtherincluding a movable component attached to the outer surface of theelongate tube, the movable component including a distal portion, themovable component being movable between an unexpanded position in whichthe movable component is disposed in abutting engagement with the outersurface of the elongate tube and an expanded position in which thedistal portion of the movable component bows outwardly from the outersurface of the elongate tube.
 38. The gastric tube as recited in claim37, wherein the movable component is slidably coupled to the proximalend portion of the elongate tube and fixedly coupled to the distal endportion of the elongate tube.
 39. A method of performing bariatricsurgery, comprising: inserting a gastric tube into an oral cavity of apatient, the gastric tube including: an elongate tube having a proximalend portion and a distal end portion, the elongate tube defining a lumenalong a length thereof, the proximal end portion defining an opening incommunication with the lumen, the elongate tube including: a blunt tipformed on the distal end portion; and an outer surface that extendsbetween the proximal and distal end portions and defines a side openingin communication with the lumen, the side opening configured anddimensioned for at least one of aspiration or irrigation; and acannulated plug coupled to the elongate tube, the cannulated plugincluding: a proximal end configured for connection to a vacuum source;and a distal end configured for removable receipt in the opening of theproximal end portion of the elongate tube to control a flow of one ofaspiration or irrigation through the lumen; guiding the gastric tubealong an enteral pathway; repositioning the gastric tube based on anobserved position of the blunt tip to a selected position within astomach of the patient; aspirating fluid from the stomach through theside opening of the elongate tube; removing the cannulated plug from theopening of the proximal end portion; anchoring the gastric tube to theselected position; and transecting a portion of the stomach.
 40. Themethod of performing bariatric surgery as recited in claim 39, furtherincluding moving a movable component supported on the elongate tube froman unexpanded configuration to an expanded configuration in which themovable component bows outwardly from the outer surface of the elongatetube into engagement with a portion of the stomach.
 41. The method ofperforming bariatric surgery as recited in claim 40, wherein moving themovable component includes sliding the movable component in a distaldirection relative to the elongate tube.